Active NPI
Carissa M Broughman, LPTA
- Physical Therapy Assistant
- Low Moor, VA
National Provider Identifier
1992268809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306603866
- Practice address
- 2901 Selma- Low Moor Rd
Low Moor, VA 24457-9998 - Phone
- (540) 862-0068
- NPI assigned
- Apr 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306603866 | VA | Primary |
Addresses
Primary practice location
2901 Selma- Low Moor Rd
Low Moor, VA 24457-9998
Mailing address
2901 Selma Low Moor Rd
Low Moor, VA 24457
Phone (540) 862-0068
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2306603866 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554681600000",
"number": "1992268809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 SELMA LOW MOOR RD",
"city": "LOW MOOR",
"state": "VA",
"postal_code": "24457",
"telephone_number": "540-862-0068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 SELMA- LOW MOOR RD",
"city": "LOW MOOR",
"state": "VA",
"postal_code": "244579998",
"telephone_number": "540-862-0068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUGHMAN",
"first_name": "CARISSA",
"middle_name": "M",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-08",
"last_updated": "2019-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306603866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Low Moor, VA
- Bruce C Banning Jr., M.D.
- Anthony Barrera, M.D.
- Demetria Shawnte Bates, DNP, FNP-BC
- Aloura Behrens, APRN NP
- James L Brewer III, MD
- Barry S Brown, DO
- Columbia-Alleghany Regional Hospital Inc
- Columbia-Alleghany Regional Hospital Inc
- Columbia-Alleghany Regional Hospital Inc
- Columbia-Alleghany Regional Hospital Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.